Provider Demographics
NPI:1255487252
Name:HARRIS, JOHN DAVID (AUD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:HARRIS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 HARRISON ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7442
Mailing Address - Country:US
Mailing Address - Phone:870-793-6244
Mailing Address - Fax:870-793-5884
Practice Address - Street 1:2000 HARRISON ST
Practice Address - Street 2:SUITE C
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7442
Practice Address - Country:US
Practice Address - Phone:870-793-6244
Practice Address - Fax:870-793-5884
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA#205231H00000X, 231HA2400X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner